Patients returning to cosmetic surgery as recession loosens grip

The health care austerity that the recession imposed on some patients may be starting to ease as the economy improves -- if the growth in cosmetic procedures during the past year is any indication.

"The economy is showing signs of improvement, and financially things are a little better for people this year," said Phillip Haeck, MD, president of the American Society of Plastic Surgeons.

The number of cosmetic procedures grew 5% from 12.5 million in 2009 to 13.1 million in 2010, according to an annual report issued Feb. 7 by the American Society of Plastic Surgeons. Surgeries increased by 2%, primarily because more people received breast augmentation, tummy tucks and liposuction. Minimally invasive procedures grew by 5%, which was mostly the result of an increase in the use of botulinum toxin, soft tissue fillers and laser hair removal.

Experts suspect this is because patients who became more fiscally conservative during the recession are more confident about their financial futures and spending money. Whether this will spill over to others who would like cosmetic surgery or have various medical needs is unclear.

"It's certainly a signal of recovery," said Gloria Bazzoli, PhD, the Bon Secours professor of health administration at Virginia Commonwealth University in Richmond. "But the economy is still on shaky ground, especially for those with moderate to low incomes. A lot depends on how confident people feel about their jobs and their health insurance."

The recession officially began in December 2007 and ended in June 2009, according to the National Bureau of Economic Research. Along with the recession's official end, experts say other factors such as the aging of the baby boomers and pent-up demand may be playing a role.

"As the aging population continues to grow, people are investing in plastic surgery procedures to help stay competitive in the workplace," Dr. Haeck said. "There's some pent-up demand for cosmetic surgical procedures. People have waited a couple of years or more to have procedures until their finances were at least somewhat back in order. But all indications are more consumers are again willing to spend more to look better."

The number of cosmetic procedures declined 1% in 2009, with surgeries dropping by 9%. Minimally invasive procedures, which tend to be less expensive, went up by 1%. Cosmetic procedures grew by 3% in 2008. Surgeries went down by 9%, and minimally invasive procedures increased by 5%.

Although health economists say it is unclear what the cosmetic surgery statistics portend for other parts of the health care sector, a second report indicated that consumers believe they will be more able to pay for needed health services.

"We're turning a corner with fewer consumers reporting delays or canceled health care treatment," said Gary Pickens, PhD, chief research officer at Thomson Reuters' Center for Healthcare Analytics. "As a result, consumers predict a significant improvement in their ability to pay for health care treatment and services in the coming months."

Reuters' Consumer Healthcare Sentiment Index released Feb. 8 hit 98 in January and 97 in December. This marks a recovery from a low of 95 in July 2010. The baseline is 100.

The measure of patient expectations for the future was better than experiences in the immediate past. The retrospective index, which measures whether patients delayed or deferred medical care during the previous three months, declined from 99 in December 2010 to 97 in January. The prospective index, which measures how patients feel about their ability to pay for medical care in the future, rose to 99 in January from 96 in December 2010.

Elective procedures, which include a wide range of nonemergency medical services such as cosmetic procedures and joint replacements, drove much of this growth. Researchers said, however, that the index needs to be tracked for a longer period before using it to project the future state of the health care industry. This index launched in December 2009.

"Consumers were more optimistic in January about elective surgeries than any of the other factors, which I find interesting, but we don't know yet what will happen in 2011," said Julie Shook, product director of Thomson Reuters' Center for Healthcare Analytics.

A third recent report was pessimistic. Demand for health care is not expected to return to prerecession levels in the immediate future, according to a special comment issued Feb. 16 by Moody's Investors Service.

Employers providing health insurance increased deductibles and co-pays during the recession, which changed patient behavior. This is unlikely to change as the economy improves, the authors wrote. However, Moody's wrote that health spending would go up if an improving economy leads to more people employed with benefits and a greater number of people become insured under health system reform.